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<Prudent Strategies in Taking Out Medical Insurance> pdf (Chinese Version only)

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Seven basic "must-knows" when taking out medical insurance

Frequently Asked Questions
Smart Tips

Items to be aware of before filing a claim

Regardless of group or individual medical insurance, the following documents must be submitted when filing a claim:

  1. the official receipt from a registered doctor, which must include the date of consultation, diagnosis of illness, name of doctor with signature and the consultation fee;
  2. doctor’s certificate, medical report and the relevant documents in support; and
  3. claim form duly completed.
(When filing a claim, a policyholder must submit hospital or registered doctor's official receipt, and the completed claim form.)

 

Tips for Claiming Medical Insurance

The purpose of taking out medical insurance is to obtain protection in case of need. To ensure that one’s insured interest will not be prejudiced, some experts recommend that policyholders should understand clearly what to watch out when making a claim to avoid unnecessary dispute, for example: claim procedure, the deadline for filing a claim, the required documents, etc.

Claim procedures – what you must know

Simon sprained his left ankle and back when playing soccer.  He consulted a number of doctors until he turned better after a few months.  He then filed a claim to the insurance company.  "After I have filed the claim form, my agent called me and told me that I had not missed the deadline.” said Simon.  “If I handed in the claim form a couple of days later, I would have missed my claim submission period.  The insurance company has the right to reject my claim.  My agent reminded me to provide all medical reports and receipts so as not to delay the progress of claim."

Claims made easy if you understand the procedures

According to insurance practitioners, there is a deadline for filing a claim under medical policies generally.  Policyholders have to, within a specified period, complete the claim form and submit it to the insurance company for processing of claim together with the medical receipt, doctor’s report and relevant documents in support.  For example, if the claim period allowed in the policy is six months, that means a policyholder must file a claim within six months from the date he first consults a doctor.  It does not mean that he can file the claim after he is fully recovered, because the claim period may have elapsed then.  At such time, the insurance company also has the right to reject his claim according to the policy term.

Medical claim 1-2-3
Step 1
Policyholder should complete the claim form and submit it to the insurance company within the allowed submission period together with the medical report, relevant documents and official receipt.
Step 2
Insurance company will process the claims submitted/
ask for supplementary information and documents.
Step 3
Insurance company will settle claims admissible / rejects claims disqualified.